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General NPI Number Information
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NPI Number | 1407054687
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Entity Type | Organization
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Legal Business Name | BRENNAN CHIROPRACTIC HEALTH CENTER
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 13754 1ST ST SUITE 1
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City | BECKER
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State | MN
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Zip | 55308-9337
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Country | US
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Telephone | 763-261-5100
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Fax | 763-261-5100
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Provider Business Mailing Address
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Address Line | 13754 1ST ST SUITE 1
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City | BECKER
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State | MN
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Zip | 55308-9337
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Country | US
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Telephone | 763-261-5100
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Fax | 763-261-5100
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/ CHIROPRACTO
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Name | MR. JOHN PATRICK BRENNAN
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Credential | D.C.
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Telephone | 763-261-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2768
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License Number State | MN
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